Template

Blockage Repair Checklist

by Rod Davey, from the Community

Use this telecom blockage repair form to capture risk assessments, pre-start and site setup photos, duct exposure and repair evidence, and HAUC-compliant reinstatement details. Record dig dimensions, surface types, grid references, and completion status, including roping, cabling, and backfill materials. Ensure jobs are documented with clear aspect photos and sign-off to meet safety and quality standards.

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Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
SF11 PIA Blockage Report Template
Use the SF11 PIA Blockage Report to capture evidence of duct or chamber blockages across telecom infrastructure works. Record job and location details, surface type, dig dimensions, photos before and after repair, duct repair steps, backfill and reinstatement layers, and site safety. Include Openreach references, status, and completion notes so teams can progress works or escalate issues with clear documentation.
by John Whitehead, from the Community
Downloads: 10+
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Template
Reinstatement Works Checklist
Use this Reinstatement Works checklist to plan and document street excavation reinstatement. Capture pre-start site photos and correct Chapter 8 traffic management, complete a suitable risk assessment POWRA, and record materials used, depths, and HAUC-compliant reinstatement types. Document compacted backfill, edge sealing, base and surface course measurements with perspective photos, and dig dimensions by surface type. Log grid references for start and end points, note completion status, and attach clear site handover images. Designed for gangs and supervisors to validate quality, safety, and compliance.
by Rod Davey, from the Community
Downloads: 0
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Template
CF SPO - Blockage Clearance Form
Use this CF SPO blockage clearance form to document BT Openreach duct or pole issues and the steps taken to clear and repair them. Capture site information, A55 and permit references, CAT and Genny test confirmation, and pre-excavation images. Provide BT Openreach evidence including damaged duct photos, repair kit in place, and post-reinstatement images. Record work type, dig dimensions, surface type, and site setup with SLG. Document reinstatement requirements and upload images for open trench, repaired duct, reinstatement completion, and site clear. Finish with certification that all works were completed satisfactorily.
by Nauman Rehman, from the Community
Downloads: 0
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Template
Reinstatement Blockage Checklist
Use this checklist to document reinstatement works for blockage repairs. Capture site setup, permits, utilities marking, and hazard checks. Record excavation details with photos of initial dig, blockage, repair, sub base, sand and marker tape, and final surface (tarmac or verge). Enter measurements (length x width x depth) and coordinates (Eastings and Northings) to satisfy council requirements. Include bitumen use, reinstatement steps, site clearance, and completion time and date. Supports multiple blockages with repeatable sections.
by Kyan Snowden, from the Community
Downloads: 0
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SF11 PIA Blockage Report Template

Use the SF11 PIA Blockage Report to capture evidence of duct or chamber blockages across telecom infrastructure works. Record job and location details, surface type, dig dimensions, photos before and after repair, duct repair steps, backfill and reinstatement layers, and site safety. Include Openreach references, status, and completion notes so teams can progress works or escalate issues with clear documentation.

by John Whitehead, from the Community

10+

Get

Template

Reinstatement Works Checklist

Use this Reinstatement Works checklist to plan and document street excavation reinstatement. Capture pre-start site photos and correct Chapter 8 traffic management, complete a suitable risk assessment POWRA, and record materials used, depths, and HAUC-compliant reinstatement types. Document compacted backfill, edge sealing, base and surface course measurements with perspective photos, and dig dimensions by surface type. Log grid references for start and end points, note completion status, and attach clear site handover images. Designed for gangs and supervisors to validate quality, safety, and compliance.

by Rod Davey, from the Community

Get

Template

CF SPO - Blockage Clearance Form

Use this CF SPO blockage clearance form to document BT Openreach duct or pole issues and the steps taken to clear and repair them. Capture site information, A55 and permit references, CAT and Genny test confirmation, and pre-excavation images. Provide BT Openreach evidence including damaged duct photos, repair kit in place, and post-reinstatement images. Record work type, dig dimensions, surface type, and site setup with SLG. Document reinstatement requirements and upload images for open trench, repaired duct, reinstatement completion, and site clear. Finish with certification that all works were completed satisfactorily.

by Nauman Rehman, from the Community

Get

Template

Reinstatement Blockage Checklist

Use this checklist to document reinstatement works for blockage repairs. Capture site setup, permits, utilities marking, and hazard checks. Record excavation details with photos of initial dig, blockage, repair, sub base, sand and marker tape, and final surface (tarmac or verge). Enter measurements (length x width x depth) and coordinates (Eastings and Northings) to satisfy council requirements. Include bitumen use, reinstatement steps, site clearance, and completion time and date. Supports multiple blockages with repeatable sections.

by Kyan Snowden, from the Community

Get

Blockage Repair Checklist

About author

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SF11 PIA Blockage Report Template

Reinstatement Works Checklist

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Reinstatement Blockage Checklist

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SF11 PIA Blockage Report Template

Reinstatement Works Checklist

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Reinstatement Blockage Checklist